Non-Pharmacological Interventions for Symptom Cluster Management in Women with Cancer: A Scoping Review of Multicomponent and Mechanism-Based Approaches

Novi Irmala,1 Tetti Solehati,2 Sukmawati Sukmawati2 1Master of Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, Indonesia; 2Department of Maternity Nursing, Faculty of Nursing, Universitas Padjadjaran, Sumedang, West Java, IndonesiaCorrespondence: Tetti Solehati, Department of Maternity Nursing, Faculty of Nursing, Universitas Padjadjaran, Jl. Raya Bandung-Sumedang KM 21, Hegarmanah, Jatinangor, Sumedang, West Java, 45363, Indonesia, Tel +62 81224836837, Fax +6222-7795596, Email tetti.solehati@unpad.ac.idBackground: Women with cancer frequently experience co-occurring symptoms, including cancer-related fatigue, sleep disturbance, and psychological distress, which negatively impact quality of life. Despite the increasing use of non-pharmacological interventions, current approaches remain largely fragmented and predominantly target individual symptoms rather than symptom clusters, highlighting the urgent need for integrated, cluster-based intervention models in women’s cancer care.Purpose: This scoping review aimed to map recent non-pharmacological interventions for symptom management in women with cancer and to examine the extent to which these interventions address co-occurring symptom clusters.Methods: A scoping review was conducted following Arksey and O’Malley’s framework and the Joanna Briggs Institute (JBI) guidance, and reported in accordance with PRISMA-ScR. A systematic search of PubMed, CINAHL, and Scopus identified studies published between January 2021 and December 2025. Eligible studies included experimental and quasi-experimental designs evaluating non-pharmacological interventions targeting fatigue, sleep disturbance, psychological distress, or related outcomes in women with cancer. Data were charted and synthesized descriptively.Results: A total of 29 studies were included, predominantly randomized controlled trials. Interventions were categorized into five categories: exercise-based programs, mind–body and relaxation therapies, complementary therapies, psychosocial and behavioral interventions, and technology-based or nurse-led care models. Exercise-based interventions consistently reduced fatigue, likely through improvements in physical capacity. Mind–body approaches improved psychological distress and sleep quality by modulating stress responses. Psychosocial interventions enhanced coping and emotional regulation, while complementary therapies provided short-term relief of subjective symptoms, although with greater variability. Technology-based and nurse-led interventions improved accessibility, adherence, and self-management. While many interventions were associated with improvements in individual symptoms, multicomponent approaches demonstrated broader and more sustained benefits across fatigue, sleep, and psychological outcomes. However, only a limited number of studies explicitly incorporated a symptom-cluster framework.Conclusion: Non-pharmacological interventions are associated with meaningful improvements in symptom burden among women with cancer. However, a critical gap persists between the multidimensional nature of symptom experience and the predominantly single-modality design of interventions. Future research should prioritize the development of integrated, multicomponent strategies explicitly targeting symptom clusters to enhance clinical effectiveness and patient-centered care.